Hi,
Verapamil and Imigran work in different ways. Verapamil is a preventative, in other words you take it daily to prevent CH's from occurring, so there's no point taking it only when you feel the headache as it will do nothing to relieve the pain. It takes time to build up in your system and start working. Normally you start taking it when the cluster period starts and it takes a few days to kick in and stop the CH's from occurring. Sometimes you still get shadows of a CH but even they should stop after a few weeks. You keep taking Verapamil for 6 to 8 weeks until the cluster period is over, then taper off over a week or two. For some people where the CH's return when they taper off, Verapamil is prescribed long term where they take it every day all year, generally at a low dose.
Verapamil has a side effect of lowering blood pressure so you should have regular check of you BP and check with your GP about taking other medication which may also lower blood pressure. Verapamil can also upset your digestive system a bit, especially when you first start taking it, so it's recommended to always take with a meal.
I've only used Imigran a few times but from what I understand Imigran is an abortive, so you use it only when you feel the headache coming on. It generally stops or reduces the pain in 5 to 15 minutes. It does not stop the CH's so you need to take it again the next time you feel a headache coming on, and the next time etc. Imigran is generally used by CH sufferers who cannot use Verapamil or who have found Verapamil does not work for them.
Another good abortive which works for many CH sufferers is Oxygen. Check out the info on O2 on this website and in the forums.
You should probably check with your pharmacist about interactions with the other medications you mention. Pharmacists have a lot of understanding about interactions and should be able to help. Make sure you ask to talk to the pharmacist and not just the person at the checkout. You can also check with your GP.
Hope you kick the CH's
Cheers,
Bruce
